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HomeMy WebLinkAboutNCS000582_MONITORING INFO_20190202vv Z 1--2, 0 STORMWATER DIVISION CODING SHEET NCS PERMITS PERMIT NO. DOC TYPE ❑FINAL PERMIT LDS MONITORING REPORTS ❑ APPLICATION ❑ COMPLIANCE ❑ OTHER DO) 61 Ua tQ DOC DATE ❑ YYYYMMDD Permit Number NCs 000582 STORMWATER DISCHARGE OUTFALL (SDO) RECEIVM�'V["['ORING REPORT JAN 0 2 2019 CENTPJkL FILES FACILITY NAME Ennis -Flint (High Point facilit}i -WR Sf=C"Tirlokr PERSON COLLECTING SAMPLE(s) Nicholas Murphrey CERTIFIED LABORATORY(S) Pace Analytical Lab # 375 Lab # Part A: Specific Monitoring Requirements SAMPLES COLLECTED DURING CALENDAR YEAR: ZO l 8 (This monitoring report shall be received by the Division no later than 30 days from the date the facility receives the sampling results front the laboratory.) COUNTY Guilford PHONE NO. ( 336) 475-6600 SIGNA'I'URE OF PER1 ITTEE OR DESIGNEE RE OUIREI ON PACE 2. Outfall No. Date Sample Collected [50050 [011530 [00310� r003'40 LU61a r [00400.>. I'oYat Flory if a total Rainfall Total Susp. Solids �T5S Biochem. Oxy. Demand BOI) rChemical Oxy. Demand C011 Ammoniast ;l Nitro n': �Py` t� mo/da/1-7 R [\1G [inches [m IL m IL �L - �lr „_ _ f iSU benchmark -- -- -- 100 30 120 8.4 6.0 - 8.0 001 10/10/18 -- 0.3 36.3 1.85 16.7 0.258 7.8 Does this facility perform Vehicle Maintenance Activities rising more than 55 gallons of new motor oil per month? _ yes X110 (if yes, complete Part B) Part B: Vehicle Maintenance Activity Monitoring Requirements OuffiII No. Sample Gollected� M [00556 [110530 [600U.:. Total Flow it a Lcable (1 PP ) Total Rainfall Oil K Grease tt a l ( PP •)P' Not�all U&GSus (illet'r-t`� a 1.`' Total' ended r.'1 pli . r $ ; _ 'New ,Motor P. Oil Usage . Int�/aaitr LAIC finches 5 ?l " nt 11 : n 4 inii gal/mo Fonts SWU-247. last remised 21212012 Page I of 2 STORM EVENT CHARACTERISTICS: Date 10/ 10/ 18 `total Event Precipitation (inches): 0.3 Event Duration (hours): (only it'applicable — see permit.) (if more than one storm event was sampled) Date Total Event Precipitation (inches): Event Duration (hours); (only if applicable— see permit.) Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 "1 certify, under penalty of law, that this document and all attachments were prepared under niy direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. [lased on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of tines and imprisonment for knowing violations." 1nAf, (Signature of Permitte � �(D e)� Form SWU-247. fast revised 1212012 Page 2 of aceAnalytical ° ANALYTICAL REPORT Natronar Carver for resting 3 Innovatlon October 19, 2018 1 I Piedmont Geologic Sample Delivery Group: L1033707 Samples Received: 10/11/2018 Project Number: 1814 Description: Ennis -Flint Nigh -Point Report To: Pete Dressel 6003 Chapel Hill Rd Ste 145 Raleigh, NC 27607 Entire Report Reviewed By: 4�4L Heather J Wagner Project Manager Results relate only to the items tested or calValed dnd are reported as rounded values. This test report shall not be reptoduced, except in full, without written approval of the laboratory. Where applicable. sampling conducted by Pace Nalrona4 �; ' - '."• -�, is performed per guidance promded in laboratory standard operating procedures, 060302, 060303, and 06U TABLE OF CONTENTS ONE LAB IVAnOV4V16t. � Cp: Cover Page 1 Tc: Table of Contents 2 EP Ss: Sample Summary 3 Cn: Case Narrative 4 Sr: Sample Results 5 3SS OUTFALL 001 L1033707-01 5 Qc: Quality Control Summary 6 Fn] Gravimetric Analysis by Method 2540 D-2011 6 s 5r Wet Chemistry by Method 350.1 7 Wet Chemistry by Method 410.4 8 6QC Wet Chemistry by Method 5210 B-2011 9 Gl: Glossary of Terms 11 E Al: Accreditations & Locations 12 4A1 Sc: Sample Chain of Custody 13 95c ACCOUNT: PROJECT: SDG: DATE)TIME: PAGE: Piedmont Geologic 1814 L1033707 10/1911811:58 2 of 14 SAMPLE SUMMARY ONELAB.NATIONWDE. Collected by Collected oxwtime R.:eived tlattaurm, OUTFALL 001 L1033707-01 WW VrC11010;Murphiey INNS 11SO 10-11i130345 LFc I P Method Gravimetaic Analysis by Method 2540 D-2011 Wet Chemistry by Method 350.1 Wet Chemistry by Method 410.4 Wet Chemistry by Method 5210 B-2011 Batch — -- WGIIS1004 WG1179834 WG1160700 WG1179325 Dilution Preparation datertimc 1 10117l18 15:05 1 1011511813',51 1 1011411809:D7 1 10111118 14:15 Analysis datwume 10117l181T,06 1011511813'51 10,14/18 13,09 101161181122 Analyst ASS JER TH BLB ACCOUNT: PROJECT: SDG: Piedmont Geologic 1814 L1033707 DATEITIME: 10A9/18 11:58 PAG E: 3of14 CASE NARRATIVE oN'ELAB. NAfIOVWIDE. r`* Cp All sample aliquots were received at the correct temperature, in the proper containers, with the appropriate preservatives, and within method specified holding times, unless qualified or notated within the report. Where applicable, all MDL (LOD) and RDL (1-00) values reported for environmental samples Tc have been corrected for the dilution factor used in the analysis. All Method and Batch Quality Control are within established criteria except where addressed in this case narrative, a non-conformance form or properly qualified within the sample results. By my digital signature below, I affirm to the best of my E knowledge, all problems/anomalies observed by the laboratory as having the potential to affect the quality of the data have beer identified by the laboratory, and no information or data have been knowingly withheld that would affect the quality of the data. Fr FC 4�z 7 GI Heather J Wagner Project Manager , FE ACCOUNT: PROJECT; SDG: DATEITIME: PAGE: Piedmont Geologic 1814 L1033707 1OA9/18 11:58 4 of 14 OUTFALL 001 SAMPLE RESULTS - 01 ONE LAB. NATIONWIDE. � Collected dateftime: 10l10118 11:50 L1033707 Additional Information Result Units E Analyte �su- ---.— __--- ��r� -- -- --- PH ;on Site) 7.8 FC Gravimetric Analysis by Method 2540 D-2011 FS1 Result Qualifier RDL Dilution Analysis Batch Analyte ugll 0g11 date ttime Cn Suspended Solids 36300 3580 1 10117120181TOG WG1181004 Wet Chemistry by Method 350.1 Result Qualifier RDL Dilution Analysis Batch 6 Analyte ugd ugil date ! lime Ammonia Ammonia Nitrogen 258 100 1 10115l201813,51 W01179834 Wet Chemistry by Method 410.4 F Result Qualifier RDL Dilution Analysis Batch Ai Analyte ug11 ugll date ! time COD 16700 10000 1 101141201813:09 WG1180700 FC Wet Chemistry by Method 5210 B-2011 Result Qualifier RDL Dilution Analysis Batch Analyte ugm ugll date ! lime BOD MO 1020 1 10116/201811,22 WGI179326 ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE: Piedmont Geologic 1814 L1033707 10/1911811:58 5 of 14 WG1181004 QUALITY CONTROL SUMMARY ONE LAB. NATIONWIDE. Gravimetric.Analysis by. Method 2540 0.2011 L1033707.01 Method Blank (MB) C (MB) R3351970-1 10/17/18 17:06 p MB Result MB 0ualifier MB MDL MB RDL Analyte ugll ugll ug11 E Suspended Solids U 350 2500 E L1033741-01 Original Sample (OS) • Duplicate (DUP) (OS) L1033741-01 10/17/18 17:06 • (DUP( R3351970-4 10/17/18 17:06 E Original Result DUP Result Dilution DUP RPD DUP Oualifier DUP RPD Limits s Analyte ugll ugll % 9G Suspended Solids 114000 114000 1 0.000 5 L1033746-01 Original Sample (OS) • Duplicate (DUP) �GI (OS) L1033746-01 10/17/18 17-06 • (DUP) R3351970-5 10/17/18 17:06 Original Result DUP Result Dilution DUP RPD DUP Oualifier DUP RPD Limits AI Analyte ugil ugA % % Suspended Solids 218000 216000 1 0.922 5 µ Rc Laboratory Control Sample (LCS) (LCS) R3351970-2 10/17/18 17:06 Spike Amount LCS Result LCS Rec. Re[. Limits LCS Qualifier Analyte ugll ugll % % Suspended Solids 773000 816000 106 85.0-115 ACCOUNT: PROJECT: SDG: DATETIMEr PAGE: Piedmont Geologic 1814 L1033707 IDY19/18 11;5B 6 of 14 WG1179834 QUALITY CONTROL SUMMARY ONiELAS,NIATIONWIDE. Wet Chemistry by Method 350.1 L1033747-01 Method Blank (MB) C (MB} R3350803-1 10/15/18 13:17 M8 Result MB Qualifier MB MDL MB RDL Analyte ugll ug11 ugll Ammonia Nitrogen U 31.7 100 L1032785-01 Original Sample (OS) • Duplicate (DUP) (OS) Li032785-01 10/15/18 13:22 • (DUP) R3350803-4 10/15/18 13:24 Original Result DUP Result Dilution DUP RPD DUP Qualifier DUP RPD Limits AnaMe ug11 ugll % % Ammonia Nitrogen 265 260 1 1.90 L1033720-05 Original Sample (OS) • Duplicate (DUP) 10 (OS) L1033720-05 10/15/18 13:52 • (DUP) R3350803-6 10/15/18 13:59 Original Result DUP Result Dilution DUP RPD OUP Qualifier DUP RPD Limits Analyte ugll ugll % % Ammonia Nitrogen ND 47,0 1 MOO 10 Laboratory Control Sample (LCS) • Laboratory Control Sample Duplicate (LCSD) (LCS) R3350803-2 10115718 13:19 • (LCSD) R3350803-3 10/15/18 13:20 Spike Amount LCS Result LCSD Result LCS Rec. LCSD Rec. Rec, Limits LCS Qualifier LCSD Qualifier RPO RPD Limits Analyte ugll ugA ugll % % % % % Ammonia Nitrogen 7500 7290 7350 97.1 97.9 90.0-110 0.820 10 L1032785-02 Original Sample (OS) • Matrix Spike (MS) (OS) L1032785-02 i0115118 13:25 • (MS) R3350803-5 10/15/16 13:27 Spike Amount Original Result MS Result MS Rec. Dilution Rec. Limits MS Qualifier AnaMe ugA ugll ugA % % Ammonia Nilrogen 5000 281 5020 94.7 1 90.0-110 L1033759-02 Original Sample (OS) • Matrix Spike (MS) • Matrix Spike Duplicate (MSD) (OS) L1033759-02 10/15/18 14:00 • (MS) R3350803-7 10/15/18 14 02 • (M51D) R3350803-8 10/15/18 14:03 Spike Amount Original Result MS Result MSD Result MS Rec. MSD Rec. Analyte ugll ugll ug/l ug11 % % Ammonia Nitrogen 5000 7860 12100 12100 64.4 84.6 ACCOUNT. _ PROJECT: Piedmont Geologic 1814 Dilution Rec. Limits MS Qualifier MSD Qualifier RPD RPD Limits 1 90.0-110 E J5 E J6 0.0662 10 SDG: DATEITIME; PAGE: 1-1033707 10r19»8 i1:58 7 cf 14 WG1180700 QUALITY CONTROL SUMMARY ONE LAS, NAWNWIDE. 4* Wet Chemistry by..Method 410,4 L1033707-D1 Method Blank (MB) (MB) R3350468-1 10/14/18 13:00 MB Result MB Oualifier MB MDL MB RDL Analyte ug/l ug/l ug/l COD U 3000 10000 L1033707-01 Original Sample (OS) • Duplicate (DUP) (OS) L1033707-01 1OA4118 13:09 • (DUP) R3350468-6 10/14/18 13:09 Original Result DUP Result Dilution DUP RPD DUP Oualifier DUP RPD Limits Analyte ug/l ugn % % COD 16700 17900 1 7,31 20 L1034104-01 Original Sample (OS) • Duplicate (DUP) (OS) L1034104-01 10/14/18 13:12 • (DUP) R3350468-7 10/14/18 1113 Original Result DUP Result Dilution DUP RPD DUP Qualifier DUP RPD Limits Analyte ugn ug/l % % COD 226000 227D00 1 0.300 20 Laboratory Control Sample (LCS) • Laboratory Control Sample Duplicate (LCSD) (LCS) R3350468-2 10/14/18 13-01 • (LCSD) R3350468-3 10/14/18 13 01 Spike Amount LCS Result LCSD Result LCS Rec, LCSD Rec. Rec. Limits LCS Qualifier LCSD Oualifier RPD RPD Limits Analyte ug/l ug/l ugll % % % % % COD 242000 221000 22000C 91,1 91.0 90.0-11C L1033533-01 Original Sample (OS) • Matrix Spike (MS) • Matrix Spike Duplicate (MSD) 0.113 20 (OS) L1033533-01 10/14/18 13:07 • (MS) R3350468-4 10/14/18 13:07 • (MSD) R3350468-5 10/14/18 13108 Spike Amount Original Resuh MS Result MSD Result MS Rec. MSD Rec. Dilution Rec. Limits MS Qualifier MSD Oualifier RPD RPD Limits AnaMe ugll ugll ug/l ugll % % % % % COD 400000 66900 442000 446000 93.8 94.7 1 80 D-120 0.622 20 ACCOUNT:-- - PROJECT: SDG: DATE/TIME: PAGE: , Piedmont Geologic 1B14 L1033707 10/1911811:58 8 of 14 WG1179326 QUALITY CONTROL SUMMARY ONE LAB. NATIONWIDE Wet Chemistry by. Method 5210 B-2011 L1033707.01 Method Blank (MB) (MB) R3351078-1 10/16/18 12:20 E MB Result MB Qualifier MB MOL MB RDL Analyte Ugll ug11 Ug11 _ -CC BOD U 1000 1000 B L1033504-01 Original Sample (OS) • Duplicate (DUP) (OS) L1033504-01 10l16118 10:28 • (DUP) R3351078-6 10!16118 10:30 [�n] Original Result DUP Result Dilution DUP RPD DUP Qualifier DUP RPD Limits Analyte ugll ugll % % BOD 4700 5950 1 23 30 L1033673-02 Original Sample (OS) • Duplicate (DUP) �GI (OS) L1O33673-02 10/16/18 10:38 • (DUP) R3351078-7 10/16/18 10:40 Original Result DUP Result Dilution DUP RPD DUP Qualifier DUP RPD Limits uAl Analyte ugli ugll % % BOO ND 0.000 1 0 30 FSC L1033736-01 Original Sample (OS) • Duplicate (DUP) (OS) L1033736-01 10/16/18 11:27 • (DUP) R3351078-8 10/16/18 11:29 Original Result DUP Result Dilution DUP RPD DUP Oualifier DUP RPD Limits Analyze ugll ugrl % % BOD NO 0.000 1 0 30 L1033756-01 Original Sample (OS) • Duplicate (DUP) (OS) 11033756-01 10116118 11:44 • (DUP) P3351078-9 10/16/18 11=45 Original Result DUP Result Dilution DUP RPD DUP Qualifier DUP RPD Limits Analyte ugll ugll % % BOD 4300 3900 1 10 30 ACCOUNT: PROJECT: Piedmont Geologsc 1814 5DG: L1033707 DATEiTIME: 10A91181158 PAGE: 9of14 WG1179326 QUALITY CONTROL SUMMARY ONE LAB. NATIONWIDE. Wet Chemistry by Method 5210 B-2011 L1033707-01 L1033808-01 Original Sample (OS) • Duplicate (DUP) (OS) L1023808.01 10/16/18 1210 - (DUP) R3351078-10 10/16/18 12:16 Fp C IT Original Result DUP Result Dilution DUP RPD DUP Qualifier DUP RPD Limits Analyte ugll ugll % % ROD 17600 15200 i 15 30 � FS] Laboratory Control Sample (LCS) Cn (LCS) R3351078-2 10/16/18 09:17 Spike Amount LCS Result LCS Rec. Rec. Limits LCS Qualifier s 5r Analyte ugll ugll % % ROD 198000 189000 95.3 84.6-115 Laboratory Control Sample (LCS) FGI (LCS) R3351078-3 10/16/18 11:19 Spike Amount LCS Result LCS Rec. Rec, Limits LCS Qualifier Analyte Ugll ugll % % -- — F 80D 198000 191000 96,3 84.6-115 E Laboratory Control Sample (LCS) (LCS) R3351078-4 10/16/18 12:07 Spike Amount LCS Result LCS Rec. Rec. Limits LCS Qualifier Analyte ug/I ugll % % BOD 198000 200000 101 84.6-115 Laboratory Control Sample (LCS) (LCS) R335i078-5 10/16/18 12:17 Spike Amount LCS Result LCS Rec. Rec. Limits LCS Qualifier Analyte ug/l ugll % % BCD 198000 186000 94.1 84.6-115 ACCOUNT PROJECT: SDG: Piedmont Geologic 1814 L1033707 DATE7TIME: PAGE: 10119/1B 11:58 10 of M GLOSSARY OF TERMS ONE LAB NATIONWIDE Guide to Reading ana Understanding Your Laboratory Report The information below is designed to better explain the various terms used in your report of analytical results from the Laboratory. This is not E intended as a comprehensive explanation, and if you have additional questions please contact your project representative. Abbreviations and Definitions E MDL Method Detection Lirnit, ND Not detected at the Reporting Limit (or MDL where applicable). FS RDL Reported Detection Limit. Rec. Recovery. RPD Relative Percent Difference. FCn] SDG Sample Delivery Group. u Not detected at the Reporting Limit (or MDL where applicable). s Sr Analyte The name of the particular compound or analysis performed. Some Analyses and Methods will have multiple analytes reported. 6 If the sample matrix contains an interfering material, the sample preparation volume or weight values differ from the QC Dilution standard. or if concentrations of analytes in the sample are higher than the highest limit of concentration that the laboratory can accurately report, the sample may be diluted for analysis. If a value different than 1 is used in this field, the result reported has already been corrected for this factor. These are the target % recovery ranges or % difference value that the laboratory has historically determined as normal Limits for the method and analyte being reported. Successful OC Sample analysis will target all analytes recovered or duplicated within these ranges. Original Sample The non -spiked sample in the prep batch used to determine the Relative Percent Difference (RPD) from a quality control F sample. The Original Sample may not be included within the reported SDG. This column provides a letter and/or number designation that corresponds to additional information concerning the result Oalifier reported. If a Oualifier Is present, a definition per Qualifier is provided within the Glossary and Definitions page and FSC potentially a discussion of possibie implications of the Oualifrei in the Case Narrative if applicable. The actual analytical final result (corrected for any sample specific characteristics) reported for your sample. If there was no measurable result returned for a specific analyte, the result in this column may state "Ni (Not Detected) or "BDU Result (Below Detectable Levels). The information in the results column should always be accompanied by either an MDL (Method Detection Limit} or RDL (Reporting Detection Limit) that defines the lowest value that the laboratory could detect or report for this analyte. A brief discussion about the included sample results, including a discussion of any non -conformances to protocol Case Narrative (Cn) observed either at sample receipt by the laboratory from the field or during the analytical process. If present, there will be a section in the Case Narrative to discuss the meaning of any data qualifiers used in the report. Ouallry Control This section of the report includes the results of the laboratory quality control analyses required by procedure or Summary (Oc) analytical methods to assist in evaluating the validity of the results reported for your samples. These analyses are not being performed on your samples typically, but on laboratory generated material. This is the document created in the field when your samples were initially collected. This is used to verify the time and Sample Chain of date of collection, the person collecting the samples, and the analyses that the laboratory is requested to perform. This Custody (So) chain of custody also documents all persons (excluding commercial shippers) that have had control or possession of the samples from the time of collection until delivery to the laboratory for analysis. This section of your report will provide the results of all testing performed on your samples. These results are provided Sample Results (sr) by sample ID and are separated by the analyses performed on each sample. The header line of each analysis section for each sample will provide the name and method number for the analysis reported. Sample Summary {Ss) This section of the Analytical Report defines the specific analyses performed for each sample ID, including the dates and times of preparation and/or analysis. Qualifier Description E The analyte concentration exceeds the upper limit of the calibration range of the instrument established by the initial calibration (ICAQ. J6 The sample matrix interfered with the ability to make any accurate determination; spike value is low. ACCOUNT; PROJECT: SDG: DATE/TIME: PAGE: Piedmcni Geologic 1814 L1033707 10/19/18 M58 11 of 14 ACCREDITATIONS & LOCATIONS ONE LAB. NATIONWIDE Pace National is the only environmental laboratory accreditedlcertited to support your work nationwide from one location. One phone call. one point of contact, one laboratory. No other lab is as accessible or prepared to handle your needs throughout the country. Our capacity and capability from our single location laboratory is comparable to the collective totals of the network laboratories in our industry. The most significant benefit to our one location design is the design of our laboratory campus. The model is conducive to accelerated productivity, decreasing turn -around time, and preventing cross contamination, thus protecting sample integrity. Our focus on premium quality and prompt service allows us to be YOUR LAB OF CHOICE. Not all certifications held by the laboratory are applicable to the results reported in the attached report. Accreditation is only applicable to the test methods specified on each scope of accreditation held by Pace National. State Accreditations Alabama 40560 Nebraska NE-OS-15-05 Alaska - _ 17-026 Nevada _ _ TN-03-2002-34 -- Ar¢ona AZO612 New Hampshire _ _ _ _ _ _ _ 2975 88.0469 New Jersey-NELAP TN002 _Arkansas California - 2932 New Mexico'-- -- _ -,- - - _ nla Colorado TN00003 New York _ _ _ 117_42 Connecticut PH-0197 North Carolina Env375 Florida E87497 _ North Carolina_`- DW21704- Ge_orgia _ - NELAP _ _ North Carolina' _ _ _- 41 Georgia' _ _ 923 _ _ -� North Dakota R-140 Idaho - - - TN00003 - - — - Ohio-VAP - _ -_ _ CLOC69 Illinois 200008 Oklahoma 9915 Indiana C-TN-01 _ Oregon TN200002 Iowa _ _ _ 364 Pennsylvania 68-02979 Kansas E-10277 Rhode Island LA000356 Kentucky' ` 90011) South Carolina 84004 Kentucky 1 - - - -15 -- _ _— _ _ _ _ South Dakota — — - n1a - - - Louisiana AI30792 4 Tennessee' ` 2006 Louisiana' ` LA180010 Texas T 104704245.17.14 Maine TNO002 _ _ Texas' LABO152 Maryland 324 Utah TN00003 Massachusetts M-TNO03 Vermont Vf2006 Michigan 9958 Virginia 460132 Minnesota 047.999-395 Washington C847 Mississippi TN00003 West Virginia 233 Missouri 340 Wisconsin 9980939910 Montana CERT0085 Wyoming A2LA Third Party Federal Accreditations QLA -ISO 17025 1461.01 AIHA-LAP,LLC EMLAP 100789 A2LA- ISO 170251461.02 _ DOD 1461.01 Canada 1461.01 USDA P330-15-00234 EPA-Crypto TN00003 ' Drinking Water 2 Underground Storage Tanks 'Aquatic Toxicity ` ChemicallMicrobioiogical 5 Mold `Wastewater nla Accreditation not applicable Our Locations Pace National has sixty-four client support cecters that provide sample pickup andfor the delivery of sampling supplies- If you would like assistance from one of our support offices. please contact our main office. Pace National performs all testing at our central laboratory. WA IR MT ND OR MN T ID SD T VVI NY WY MI T T T NV uT NE IA off T PA T T IL Ili` T T T GA CO KS MO T KY avv VAT T • T N TLT TAZ NM OK AR T Ili, M$ AL GA T Tx T LA T e AK T T . d FL H1 ACCOUNT: C/ PROJECT: SDG: DATEITIME: Piedmont Geologic 1814 L1033707 10/1911811:58 ME PAG E: 12 of 14 -a tpany Name/Address: Billing InlormatiAn: AnaF"s f Container / Preservaiije main 01 Cultody Pace of Piedmont Geologic*ESC 64D03-145 Chapel Hill Road': NC 27607 - F;talelgh, � ' ' .: o (/) - :70f.51. h�ran R� Mw J)J.t. YN 1711Y R,= port 10' EmailTo: Drt3ssel Pldress©I@piedrnontgeolaglc.com�Clty/State 4_2 pate � • c..; c;5 rsa ssssProl�p Ennis -Flint High -Point 11 tt_�W Colleued N+'t;:n N�, )1 E� —# � -- G 109 oe s<ri tion: , r -; E x '_2 Ftsone: (919} 854-97p0 CFent Plo ea a tab Project p p 1.- CMColtectedby{printl: Site/FaciptYIDN P.O.p blur �r to W a, a' ' �;cke1�5 p-;t C] t 0. a 0 ". =• p = �, ; Ttmpiatc: ;= Collected by (signature : Ruth? (tab MUST Be Notified) Date Resalts Needed Day Y Y E _ 9- _ prelogin:• - t tletiDar«......._.._ 1QOti �iwn ,�::_ -� eO-.• 75R: WagRer Email?tsa _Yes immediately Dar FAX? Na d �, C Pactcd an Ice . N Y _ — three Dar...-.,..„... 2S% —No, ____Yes ei ,- 0' �Q�• • r1j � f7 �, () E, Shipped Via: Sample ID Comp/Grab Matrix' Depth Date Time ntrs o .� Q - aeml�timr+snc lamtierit.0 anh1 G n I1 Q( Gra I I 1150 + ,;ry .. . ���� , -tom _ � -t _ F' • - Y �' - 7dltri.: SS - Sail GW - Groundwater WW - WaVeWater. DW - Drinl,ln& Water 07 - Othet pN Temp _ W SCREEN: <0.5 mr0ir �7 ttatd'a Remarks _ . ! •� Row Other - Rek wished by i (Si tole is Date:/ J Q. Time: Re d { ai re' a� Samples returned via: ©UPS Ccnditlon• (tab use onij) , CI ❑ FcdEM ❑ Courier ❑ iirrquisht!d by: Si$n Date: Time: Received by: (Sigrrattirej W.. �, Temp: � '� aC "Bottle.—R —red: { 5- ��` '-};rJi CE]C Seallntact:' Y,�N,NA Relinauishad' tiy TIm2: Rectnie for lab by Jrpat ? Datr , ' 1 : Tme pti l ttr eked NCF: 'AriaPace r r Innovation • Cooler Receipt FForm- Client: { 1G �t cJ SDGp jJ-�ri`► a� Caroler ReceivoLf/Opened Ow 10/ d 18 Teniperature- . Received By: eagnii Johnson �lgn:h1111'C: _ . Receipt Check List NP Yes No COC-Seal. Present'/ Intact? _ COG Signed / Accurate? Bottles arrive intact? Correct bottles used? Suffccient.volume:sent? % lf-Applicable_µ VOA Zero'headspace? Preservation Correct t5e55?